What the panel ordered
The Petition for Reconsideration was granted, the WCJ's Findings and Orders dated August 16, 2024, were rescinded, and the matter was returned to the trial level for further proceedings.
Applicant sought reconsideration of the WCJ's Findings and Orders issued on August 16, 2024, which barred the claim based on the statute of limitations. The WCJ had admitted defendant's Exhibits F and G. The WCJ filed a Report and Recommendation on the Petition for Reconsideration recommending denial. The Appeals Board granted reconsideration and rescinded the WCJ's Findings and Orders, returning the matter to the trial level for further proceedings.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The WCJ's decision to bar the claim based on the statute of limitations was not supported by substantial evidence because the defendant failed to provide sufficient proof that the DWC-1 claim form and notice were properly mailed and received by the applicant. New evidence showed returned mail to the applicant's address, undermining the presumption of proper service.
From the decision · page 3It is undisputed that "since no benefits have been provided to applicant, the only applicable limitation is one year from the May 4, 2021 claimed date of the injury." (F&O, Opinion on Decision, p. 10 citing Lab. Code, § 5405(a).) Applicant filed his claim on January 18, 2023. (Application for Adjudication, January 18, 2023.) Therefore, applicant's claim was filed more than one year from the May 4, 2021 claimed date of injury.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Defendant failed to provide substantial evidence that the DWC-1 claim form and notice were properly mailed and received by applicant.
Favours Applicant prevailed
This failure undermined the presumption of mailing and receipt, which was critical to the WCJ's statute of limitations bar.
New evidence showed mail addressed to applicant at the address used by defendant was returned undelivered.
Favours Applicant prevailed
This new evidence rebutted the presumption that the mailing was received, supporting tolling of the statute of limitations.
From the decision · page 5In addition, it now appears that there is some new evidence related to whether applicant always receives mail at his address of record, the same address used by defendant to allegedly serve the DWC-1 form. (Petition for Reconsideration, p. 3, and Exhs. 9-10.) After trial concluded, staff at the District Office of the Department of Workers' Compensation e-mailed applicant's counsel on June 18, 2024 and August 28, 2024 regarding returned mail that had been addressed to applicant at the address applicant testified at trial was his correct address. (Ibid.) It appears from the new evidence that an order issued by the WCJ on May 29, 2024 addressed to applicant at that address was returned (Exh. 9), and the F&O at issue herein addressed to applicant at that address was also returned (Exh. 10). (Ibid.)
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code section 5405(a)
Labor Code section 5405(a) - one year statute of limitations for claims where no benefits have been provided
The WCJ initially applied this statute to bar the claim as it was filed more than one year after the injury date.
From the decision · page 3It is undisputed that "since no benefits have been provided to applicant, the only applicable limitation is one year from the May 4, 2021 claimed date of the injury." (F&O, Opinion on Decision, p. 10 citing Lab. Code, § 5405(a).) Applicant filed his claim on January 18, 2023. (Application for Adjudication, January 18, 2023.) Therefore, applicant's claim was filed more than one year from the May 4, 2021 claimed date of injury.
Labor Code section 5401(a)
Labor Code section 5401(a) - employer's duty to provide claim form and notice within one day of knowledge of injury
The issue was whether the statute of limitations was tolled due to defendant's failure to provide the DWC-1 claim form and notice as required by this statute.
From the decision · page 4Within one day of receiving notice or knowledge of injury under section 5400 or 5402, which injury results in lost time beyond the employee's work shift at the time of injury or which results in medical treatment beyond first aid, the employer shall provide, personally or by first-class mail, a claim form and a notice of potential eligibility for benefits..."
Evid. Code section 641; Suon v. California Dairies (2018) 83 CCC 1803
Presumption of mailing and receipt under Evid. Code section 641 and Suon v. California Dairies (2018)
The WCJ relied on the presumption that a mailed document was received, but the Appeals Board found the presumption rebutted due to lack of proof of proper mailing and new evidence of returned mail.
From the decision · page 4This time could be extended in this case no later than June 9, 2021, because the claim form was mailed to applicant on June 4, 2021 at a valid address where he admitted at trial that he receives his mail, with 5 days added to June 4, 2021 due to service via US Mail. Pursuant to Suon v. California Dairies (2018) 83 CCC 1803, 1817 (appeals board en banc), the presumption that a mailed document was received is rebuttable, but a mere allegation that the recipient did not receive the mailed document is insufficient to rebut the presumption. Here, the letter sent to applicant with the DWC-1 (Exh. H) was mailed on June 4, 2021, at the same address that applicant has received other documents via mail in this case. Applicant has not rebutted the presumption that the June 4, 2021 letter and the claim form were not properly served on applicant. Furthermore, applicant testified at the second day of trial that he filed his application in January of 2023 because he couldn't find an attorney at the time, thinking that he couldn't afford one.
What proof carried it
The evidence the panel weighed, by kind.
Applicant's credible testimony that he never received the DWC-1 claim form or notice of rights
From the decision · page 1Applicant contends that the statute of limitations should not bar his claim because he was not provided with a DWC-1 claim form or notice of his rights by his employer prior to filing his claim; that applicant credibly testified that he never received any correspondence with a DWC-1 form and notice of his rights from defendant although he did confirm that a letter presented to him at trial had the correct address; that the WCJ erred in applying the mailbox rule to presume service of defendant's letter with the DWC-1 claim form and notice of rights on applicant because defendant offered no proof of service or other form of evidence that its letter was ever mailed or placed for mailing with the post office; and, that there is new evidence not discoverable prior to the hearing evidencing that mail to applicant's address as listed in the official address record and as he testified was on the letter shown to him during trial, was being returned to sender and not delivered to applicant.
Lack of proof of mailing or service of the DWC-1 claim form and notice by defendant
New evidence of returned mail addressed to applicant at the address used by defendant
From the decision · page 5In addition, it now appears that there is some new evidence related to whether applicant always receives mail at his address of record, the same address used by defendant to allegedly serve the DWC-1 form. (Petition for Reconsideration, p. 3, and Exhs. 9-10.) After trial concluded, staff at the District Office of the Department of Workers' Compensation e-mailed applicant's counsel on June 18, 2024 and August 28, 2024 regarding returned mail that had been addressed to applicant at the address applicant testified at trial was his correct address. (Ibid.) It appears from the new evidence that an order issued by the WCJ on May 29, 2024 addressed to applicant at that address was returned (Exh. 9), and the F&O at issue herein addressed to applicant at that address was also returned (Exh. 10). (Ibid.)
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About this page
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